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外科研究与新技术（中英文）

外科研究与新技术（中英文） ›› 2026, Vol. 15 ›› Issue (3): 214-220.doi: 10.3969/j.issn.2095-378X.2026.03.004

• 论著 • 上一篇    下一篇

基于HAPA理论的微信小程序在脑卒中患者延续性康复训练中的研究

侍伟伟1, 刘玲玉2, 古秀雯3   

  1. 1.上海市养志康复医院（上海市阳光康复中心）辅具资源部,上海 201619;
    2.上海市养志康复医院（上海市阳光康复中心）神经康复科,上海 201619;
    3.上海市养志康复医院（上海市阳光康复中心）医务部,上海 201619
  • 收稿日期:2025-11-18 出版日期:2026-09-28 发布日期:2026-09-30
  • 通讯作者: 古秀雯,电子信箱：gxwen@126.com
  • 作者简介:侍伟伟（1984—）,女,硕士,高级工程师,从事医学装备新技术与康复辅具创新工作
  • 基金资助:
    上海市医院协会（X2024123）

Application of Wechat App based on HAPA theory in continuous rehabilitation training for stroke patients

SHI Weiwei1, LIU Lingyu2, GU Xiuwen3   

  1. 1. Assistive Device Resources Department, Shanghai Yangzhi Rehabilitation Hospital （Shanghai Sunshine Rehabilitation Center）, Shanghai 201619, China;
    2. Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital （Shanghai Sunshine Rehabilitation Center）, Shanghai 201619, China;
    3. Medical Affairs Department, Shanghai Yangzhi Rehabilitation Hospital （Shanghai Sunshine Rehabilitation Center）, Shanghai 201619, China
  • Received:2025-11-18 Online:2026-09-28 Published:2026-09-30

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摘要： 目的 针对脑卒中高致残率、高复发率及传统康复模式时空限制等问题,本研究结合健康行动过程取向（HAPA）理论的分阶段行为干预模型与人工智能（AI）技术,探讨基于HAPA理论的微信小程序在脑卒中患者延续性康复训练中的应用效果。方法 构建覆盖“院内-家庭-社区”全场景的智能康复系统,通过依托HAPA健康行动过程取向理论的动机激发、行为计划、行动执行、行为维持全流程分阶段干预逻辑,融合AI智能技术与微信生态优势,为脑卒中患者提供全流程、个性化的延续性康复支持。选取2025年1—4月上海市养志康复医院及中山街道卫生院收治的30例脑卒中患者作为研究对象,随机分为对照组（A组）和干预组（B组）,每组15例。A组接受常规脑卒中康复医嘱,B组在常规医嘱基础上接受基于HAPA模型的小程序AI远程康复训练干预。于干预前及干预后3个月,比较两组患者的手部关节活动度、手功能、美国国立卫生研究院卒中量表（NIHSS）评分、Berg平衡评分、Fugl-Meyer评分、改良Barthel指数及Carr-Shepherd评分。结果 干预后,B组在多项指标上均显著优于A组：NIHSS评分较低[（18.22±4.15）分vs （30.46±5.23）分,P<0.05],Berg平衡评分[（47.26±5.71）分vs （36.28±6.42）分]、Fugl-Meyer评分[（38.02±7.18）分vs （20.14±5.89）分]、改良Barthel指数[（35.26±6.54）分vs （25.45±5.77）分]及Carr-Shepherd评分[（82.73±8.25）分vs （64.35±9.11）分]均较高（均P<0.05）。此外,B组患者的手部关节活动度恢复更佳,手功能改善更明显,康复锻炼依从率也更高（73.3% vs 53.3%,P<0.05）。结论 基于HAPA理论的微信小程序能有效提升脑卒中患者的康复训练依从性,显著改善其神经功能、肢体运动功能、平衡能力及日常生活活动能力,为实现高质量的延续性康复提供可行技术支持。

关键词: 微信平台, 脑卒中, 延续性康复, 健康行动过程取向理论, 数字康复

Abstract: Objective To address the high disability and recurrence rates of stroke and the spatiotemporal limitations of traditional rehabilitation models by integrating the phased behavioral intervention model of the Health Action Process Approach （HAPA） theory with artificial intelligence （AI） technology, and investigating the application effect of a Wechat App, based on the HAPA theory, in continuous rehabilitation training for stroke patients. Methods An intelligent rehabilitation system covering the “hospital-home-community” continuum was constructed. Guided by the stage-based intervention logic of HAPA covering motivation arousal, behavioral planning, action initiation and behavioral maintenance, this study integrated AI technology and WeChat ecosystem to provide patients with whole-process, personalized rehabilitation support. Thirty stroke patients admitted to Shanghai Yangzhi Rehabilitation Hospital and Zhongshan Sub-district Health Service Center from January to April 2025 were selected and randomly divided into a control group （Group A） and an intervention group （Group B）, with 15 patients in each group. Group A received routine stroke rehabilitation orders, while Group B received AI-based remote rehabilitation training intervention via an App based on the HAPA model, in addition to routine orders. Hand joint range of motion, hand function, National Institutes of Health Stroke Scale （NIHSS） score, Berg Balance Scale score, Fugl-Meyer Assessment score, modified Barthel Index, and Carr-Shepherd score were compared between the two groups before and 3 months after the intervention. Results After the intervention, Group B showed significantly better outcomes than Group A in multiple indicators： lower NIHSS score （18.22±4.15 vs 30.46±5.23, P<0.05）, and higher Berg Balance Scale score （47.26±5.71 vs 36.28±6.42）, Fugl-Meyer Assessment score （38.02±7.18 vs 20.14±5.89）, modified Barthel Index （35.26±6.54 vs 25.45±5.77）, and Carr-Shepherd score （82.73±8.25 vs 64.35±9.11） （all P<0.05）. Furthermore, Group B demonstrated better recovery of hand joint range of motion, greater improvement in hand function, and a higher exercise compliance rate （73.3% vs 53.3%, P<0.05）. Conclusion The Wechat App, based on the HAPA theory, has been shown to effectively enhance the compliance of rehabilitation training in stroke patients, resulting in significant improvements in neurological function, limb motor function, balance ability, and activities of daily living. It provides feasible technical support for high-quality continuous rehabilitation.

Key words: Wechat platform, Stroke, Continuous rehabilitation, Health Action Process Approach, Digital rehabilitation

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